Because of what happens a frozen pregnancy. What timing problems may arise? Violations of the endocrine system prevents the normal fastening of the embryo

Not always successfully began pregnancy ends with a positive outcome. In medical practice, the most dangerous period of time when you enter the child is the first trimester, during which various complications leading to the fetal death may occur.

Measuring pregnancy - pathology, in which the fruit ceases to grow and develop, he dies in the womb. Sometimes this complication ends with spontaneous miscarriage. However, quite often the dead embryo remains in the uterus cavity, which can cause its inflammation, and in the exacerbation of the process - sepsis is a severe infectious disease in which microorganisms circulate in the blood.

10 signs of frozen pregnancy

Lack of toxicosis

The cessation of morning nausea and vomiting is a sign of frozen pregnancy in the first trimester. However, women do not always pay attention to this phenomenon, because they believe that unpleasant symptoms have just passed, and the body has adapted to the emergence of a child. As a rule, toxicosis at measuring pregnancy ends very sharply. Usually this sign is not manifested immediately after the death of the fetus, but after a few days or even weeks.

Return of the breast to the state before the conception of the child

The lack of swelling of the mammary glands and hyperpigmentation of nipples is another sign of frozen pregnancy. These changes in the chest are also sharp. In addition, signs of frozen pregnancy include a one-time cessation of the possession of the colostrum, if it is secreted earlier.

Reducing basal temperature

If a pregnant woman is watching his own, then when it is reduced, you can suspect a frasonal pregnancy. When fetal death, a temperature of less than 37 degrees Celsius is displayed on the thermometer (usually 36.4-36.9). However, according to this feature of frozen pregnancy in the first trimester, it is impossible to make sure about the diagnosis, since it is possible an incorrect measurement or error of the thermometer.

The appearance of pain

The appearance of similar with menstrual pains in the bottom of the abdomen can talk about frozen pregnancy. However, this symptom appears through a large segment of time, sometimes up to several weeks after the death of the embryo. On the contrary, pulling pains at the bottom of the abdomen, accompanied by bloody discharge, are more often talking about.

Pathological discharge from the vagina

The appearance of oscillation of vaginal vaginal secretions with streaks of blood or red can be a symptom of frozen pregnancy. But much more often this sign speaks of the start of spontaneous miscarriage.

Increase body temperature

In the presence of an infectious process in the uterus due to the decay of a dead fetus, a woman has an increase in body temperature to subfebrile values \u200b\u200b(up to 38 degrees). However, if this process begins to wear a systemic nature, it is possible to hyperthermia to very high values \u200b\u200b(40-41 degrees) and the overall serious condition of the body of the woman.

A frozen pregnancy is not a rare complication and may appear at a completely healthy woman, so when this diagnosis is noted, it is not necessary to despair strongly, since the likelihood of the next successfulness of the child and subsequent birth is 80-90%.

Lack of drowsiness, fatigue

Upon decreasing progesterone, due to the death of the fetus, its effect on the woman's body decreases. She disappears a feeling of fatigue and drowsiness. This sign of frozen pregnancy is extremely unreliable, but if there are other symptoms, a woman should be examined.

No increase in hCG

When measuring pregnancy, chorionic gonadotropin ceases to increase after the fetus death, and then it starts to decrease at all. Therefore, in suspected of this pathology, you should trace the dynamics of the HCG, passing the repeated analysis after 2-3 days.

Gynecological examination

When examining the doctor, an obstetrician gynecologist measures the volume of the uterus. During frozen pregnancy, it has its backlog in size, which can serve as a diagnostic criterion of pathology. However, this feature cannot be used in the first gestation periods, since at this time the volume of the uterus is practically no different from its dimensions before conception.

Ultrasound

During ultrasound research, the doctor may detect a frasonal pregnancy. This method is considered to be the "golden" standard in the diagnosis of this pathology. The lack of heartbeats and the lag of the fetus in size are the main symptoms of frozen pregnancy when ultrasound.

Behavior when measuring pregnancy

With the emergence of subjective symptoms of frozen pregnancy, immediately refer to the doctor for thorough diagnosis. If with the help of blood test on hgch and ultrasound, this diagnosis will be confirmed, measures are carried out to remove embryo from the uterine cavity.

Sometimes doctors occupy expectant tactics, the purpose of which is spontaneous beginning of miscarriage. When this does not happen, or the fruit died quite a long time and there is a probability of infection of the uterus, an abortion is performed. Under a period of less than 8 weeks of pregnancy, it is possible to use artificial miscarriage with.

At small periods of gestation, it is possible to use vacuum aspiration, the most secure method of surgical abortion. At the later weeks pregnancy, the uterine cavity is used. This procedure is carried out under general anesthesia, the materials obtained in its a result are sent to histological examination.

Risk group

A frozen pregnancy can occur at any, even completely a healthy woman. It is usually associated with congenital embryo anomalies that are incompatible with life or due to elevated emotional and physical exertion. The risk group for this pathology includes having unbearable sex infections, as well as those who have abortion history, or the usual unbearability. In addition, the chances of developing frozen pregnancy in individuals with such somatic diseases as diabetes, thyroid dysfunction and thyrotoxicosis are elevated.

The future mother is important to carefully examine signs of frozen pregnancy in the early stages in order to ask for medical care on time. With such pathology, women of different age are faced. The older is pregnant, the greater the risks of the anambrony. According to statistics, on average, in 15% of cases, the death of the embryo occurs.

Why does the fetus fade in early pregnancy?

This pathology does not arise unfortunately. It is provoked by certain factors. There are assumptions that frozen pregnancy early, the reasons for which it is worth determining to prevent such in the future may arise in such cases:

1. Genetic mutations are the most common factor. This pathology is manifested up to 8 weeks gestation. It is incompatible with further life.
2. Hormonal disorders. These include the lack of progesterone and an increase in the level of androgen - male hormones.
3. Infections. During the length of the Malta, the body of the future mother is strongly exposed to viruses. Fruit bubble and placenta protect the embryo. However, with the exacerbation of infections, this "armor" does not help. In addition, at high temperatures accompanying infectious diseases, the oil delivery of the fetus is worsen.
4. Problems with blood clotting. A fetal egg is not able to fix on the inside of the uterus. In addition, this pathology provokes the blockage of vessels, as a result, the embryo does not deliver the right amount of valuables, and it ceases to develop.
5. Unbalanced nutrition and an unhealthy lifestyle. This can be attributed to the poor in vitamins, excessive stress, permanent stay at a computer or TV, irregular walks and so on.

How to determine a frasonal pregnancy in the early stages?

The death of the embryo at the initial stage can proceed asymptomatic. However, there is still a number of signs that eloquently testify to the woman about the problem. It is important for her to know how a frozen pregnancy is manifested in early terms. It will help to prevent serious consequences for mother health. Neglect such symptoms is unreasonable and even dangerous.

The first signs of frozen pregnancy in the early stages

There are a number of symptoms whose manifestation should make a woman tolerance. In how to recognize a frozen pregnancy early, the body itself will tell. Special attention to the future mother should be given to such symptoms:

1. Sudden disappearance of toxicosis. If early beds are sharply and unfortunately walks, time to beat the alarm.
2. Softening of breasts. After conception, the women notice that the dairy glands increased and became painful. For the entire period of navigation, the crumbs of the chest can relax and pour. In such an alternation there is nothing anti-abnormal, because it is associated with hormonal "jumps" in the body. However, if in the 1st trimester of pregnancy, the dairy glands relax, it can be a sign of fetal fetal. There are other "provocateurs" of breast softening. For this reason, it is not worth panicing during the manifestation of this feature.

Selection when measuring pregnancy in early time

If the body immediately did not get rid of the deceased egging egg, its rejection will be gradually. Family pregnancy on early term, the symptoms will be demonstrated in the form of discharge from the vagina. The consistency of the secret and its shade directly depends on how much time after the fetus death passed. Signs of frozen pregnancy in the early stages are as follows:

1. The first 2 days after the death of the embryo consistency is ordinary. They have a whitish color.
2. Starting from the 3rd and to the 6th day, the fruit egg gradually begins to flap from the walls of the uterus. As a result, bloody streaks appear in the discharge.
3. 12-14 days after the death of the embryo, the secret acquires a brown-reddish tint.

More often, pregnant women turn to the gynecologist when they notice the red discharge - signs of fetal fetal. This process is irreversible, and it is no longer possible to fix something. However, bloody allocations do not always serve as evidenced by the development of the embryo. They can signal about another pathology flowing in the body of a woman.

Feeling at a frozen pregnancy in early time

At the initial stage, the woman feels like before. However, as the expansion decomposes, the signs of fetal fetal in the early periods of pregnancy are strengthened. Along with the disappearance of toxicosis and the softening of the dairy glands, strong headaches appear. In addition, pregnant woman overwhelm the weakness and lack of forces. A month after the death of the embryo, the abdominal pain of the gravity character is manifested at the bottom of the abdomen.

BT when measured pregnancy in early time

Some women even after fertilization continue to control. With the normal flow of gestation, the thermometer should show 37 ° C. However, the temperature at a frozen pregnancy in the early time decreases. This symptom earlier than other signals the fetal death. It manifests itself as follows:

• 46-48 hours, the temperature drops to 36.8 ° C and keeps at this level a couple of days;
• after 4 days, BT is 36.7 ° C;
• when a fruit egg begins to intensively decompose, in the female body there is an inflammatory process with a sharp "jump" temperature.

Measuring Pregnancy - Diagnostics

We turn to the doctor's doctor with complaints about drawing pain or bleeding. The doctor conducts a thorough inspection, allowing him to identify the fetal fetus in the early stages. During it, the doctor compares the size of the uterus in a pregnant woman with what should be on this period of gestation. In addition, the doctor appoints additional research: and the surrender of tests for hCG. According to the results, he either confirms the death of the fetus, or refute.

Hgch when measuring pregnancy in early time

This hormone is generated intensively after attaching a fetal egg to the uterus. To determine its indicator, blood is rented in the morning on an empty stomach or during the day (4-5 hours before that there is nothing). With normally proceeding embryo, the level of hormone in the blood is increased daily. However, hgch at measuring pregnancy decreases. If the fruit died, it affects the hormone indicators as follows:

• the concentration of hCG in the blood of a woman is much lower than the period of gestation on this period;
• when the test of analysis, a decrease in the hormone indicator is noted.

In some cases, hCG may even increase, but its indicator still remains below the norm. Gynecologists believe that the "behavior" of this hormone is not yet a confirmation of the aembrian. Signs of frozen pregnancy in early periods should be taken into account in the complex. For this reason, a growth breach is just one of the symptoms. To obtain a reliable picture, the doctor will appoint other diagnostic procedures.

Ultrasound of frozen pregnancy in early time

This procedure gives reliable results when determining the aembria. If a frozen pregnancy is supposed, ultrasound will show these results:

1. The sizes of the fruit egg norm (significantly less) are not true.
2. Not "visible" (after the 5th week of gestation, it should be clearly defined).
3. The size of the embryo is less than they should be on this period of pregnancy.
4. After the 4th week of gestation, the sign of the aembronia is the deformation of the fetal egg.

Measuring Pregnancy - What to do?

If the assumptions of the doctor about the death of the embryo are confirmed, it develops a further action plan. The removal of a fetal egg from the body of a woman can be carried out as follows:

• appointment of medicines provoking miscarriage;
• scraping;
• the expectant position - after the death of the fetus, the amount of progesterone decreases, which is why spontaneous miscarriage can occur.

More often, frozen ectopic pregnancy on the early term is "interrupted" by scrolling. Such a mini-operation is performed under anesthesia. Scraping allows you to remove a completely fruit egg. However, this procedure has contraindications. Scraping is prohibited:

• in infections of genital organs;
• in case of exacerbation of chronic diseases;
• in case of bacterial infections that attacked the woman's body.

Restoration after frozen pregnancy in early time

The rehabilitation period after the scraping may last a few weeks. A woman is important to strictly implement the recommendations of the doctor:

1. It is necessary to take antibacterial drugs.
2. After scraping you need to observe the bed regime. Physical exertion can provoke bleeding.
3. Since in the first 2 weeks after the mini operation can be intensive allocations, you need to use gaskets. The use of tampons during this period is prohibited!
4. It is necessary to refrain from sex at least 2 weeks.
5. If "interrupted" a frozen pregnancy at an early term is preserved in the lower abdominal pain. They do not need to be heroically tolerated, you can drink an anesthetic.
6. It is necessary to take care of reliable contraception. Subsequent pregnancy is planning at least 6 months, or even later. By the time the body of a woman should recover.

Family pregnancy early - the consequences

If the death of the embryo is in time detected, it is possible to avoid complications for the health of a woman. Otherwise, even possible sepsis. The risk that pregnancy after frozen pregnancy will be associated with the same problems, still preserves:

1. If the aembronium in a woman arose for the first time, the probability of its repetition is up to 25%.
2. After the 2nd pathological pregnancy, the risk that the problem will repeat, is about 35%. For this reason, the future mother should carefully monitor the signs of frozen pregnancy in the early stages.
3. If the anambrium occurs 3rd times, the chance of the death of the embryo increases to 40%.

How to avoid frozen pregnancy in the early stages?

You can warn the anambrion. Previous should be understood why pregnancy is pregnant at an early term. Also future parents before conception, the full examination must be underway. A woman needs to hand over the smear to the vaginal flora, make an analysis for the presence of torch infections. The threat of fetal fret will be minimized if they refuse the destructive habits in advance. Folic acid will help to make a healthy boy. Signs of frozen pregnancy in laterally or early dates are inextricably linked and with nutrition of a woman (it should be healthy).

Froyless or impaired pregnancy is the intrauterine fetal death, which is not manifested by obvious signs of abortion. Pathological condition is found until 28 weeks of the fetus. Most often, the fading of pregnancy occurs in the early periods in the first trimester until the age of 16 of the child's development. The period is especially dangerous when there is a laying of organs and embryo systems, and the placenta is not yet formed. After the diagnosis of frozen pregnancy, the embryo is removed from the woman's uterus. In some cases, there is a spontaneous abortion.

Symptoms of frozen pregnancy in early time

The danger of undeveloped pregnancy in the early deadlines is that pathology can leak without clinical manifestations. Delayed dead embryo in the uterus leads to a gradual decomposition of his fabrics. Toxic decomposition products are absorbed into the blood of a woman, cause the organism poisoning and the development of severe complications.

Explicit clinical signs may arise in 6-7 weeks after the death of the fetus, which indicate a violation in the work of the woman's body. A frozen pregnancy in the late periods of 2 trimester is detected faster - the fetus movement ceases, which should alert a woman. Doctors warn that the planned visit to the gynecologist can eliminate not only the development of intoxication and other undesirable consequences in pregnant women, but in some cases prevent the fetus death.

Clinical signs of undervolving pregnancy, if manifest, it is quite weak. A woman may not give this meaning. It is necessary to know the symptoms of the intrauterine death of the fetus in the early stages in order to respond in a timely manner and visit the female consultation doctor, where the pregnant woman consists of a dispensary accounting.

Symptoms of frozen pregnancy:

In the occurrence of complications associated with the poisoning of the body toxic products of the decomposition of fetus tissues, explicit clinical signs occur.

1. Fever up to 40 degrees.
2. Chills, high sweating.
3. Headaches.
4. Intense pain syndrome in the lower parts of the abdomen.
5. Permanent nausea, multiple.
6. Uterine, nasal, internal bleeding.

Long inxication can lead to the development of sepsis (bacteremia, general infection of the organism) and DVS syndrome (violation of blood coagulation, massive bleeding).

Signs of frozen pregnancy in early time

Diagnose undeveloped pregnancy can a gynecologist according to specific features that are characteristic of the intrauterine fetal death. The specialist also assigns additional methods of examination, which confirm the disappointing sentence. Only after the appeal to women's consultation can be said with confidence that the embryo died, and the pregnancy stopped development. Before visiting a specialist should not make premature conclusions.

To suspect a frozen pregnancy can be at home by change. To do this, it is necessary to measure the thermal temperature in the rectum in the morning after sleep without getting out of bed. For pregnancy, female sex hormone is responsible, which causes an increase of 0.3-0.5 degrees.

The normal flow of intrauterine corresponds to the temperature in the rectum at the level of 37.2-37.5 degrees. The decline in this indicator indicates a violation of the course of pregnancy and the possible death of the fetus. It must be remembered that a low indicator is not an absolute sign of frozen pregnancy. When identifying a basal symptom, it is necessary to consult a gynecologist.

At the reception, the doctor collects a woman's complaints, inspection, including a gynecological chair, prescribes laboratory and instrumental examination methods. In the early periods of the fetus of the fetus, the most informative ultrasound diagnostics of the embryo and laboratory analysis on the detection of concentration (chorionic gonadotropin of a person) in peripheral blood.

Causes of frozen pregnancy

In most cases, it is possible to identify the cause of undeveloped pregnancy and with further planning of conception to undergo a course of prophylactic treatment. Sometimes doctors cannot determine the cause of the intrauterine fetal death. This does not cause concerns when such pathology meets once. Repeatless pregnancy testifies to severe pathology in the body of a woman who requires a thorough examination and adequate therapy. According to statistics, the intrauterine death of the fetus is rare and is not familiar - for 200 normally occurring pregnancies there is one case of the death of the embryo in the mother's womb.

Causes of frozen pregnancy.

The usual unbearable of the fetus often causes a combination of several adverse factors. Identification of the cause of pathology is an important link in the planning of pregnancy and the birth of a healthy child.

What diagnosis of frozen pregnancy will be the most accurate?

Untrevive pregnancy in early periods are detected using laboratory and instrumental diagnostic methods. The gynecological examination is carried out before appointing the survey.

1. Inspection on the gynecological chair - allows you to determine the condition of the cervix, matching the size of the uterus. When detecting inconsistencies or pathological changes assign ultrasound diagnostics.
2. Ultrasound examination of the uterus and the fetus is the most accurate method for identifying the intrauterine death of the fetus in the early development time. Signs of frozen pregnancy: uneven contours and deformation of the fetal egg, the localization of the embryo in the lower departments of the uterine. In case of questionable results, a re-ultrasound study is carried out in 5-7 days. Stop the growth of the fruit egg or weak imbrons of the embryo testifying in favor of underdeveloped pregnancy.
3. Blood test for maintenance is an effective method for the diagnosis of intrauterine fetal death in the earliest period of pregnancy (up to 8-10 weeks) when the ultrasound examination is not informative. In the first weeks of pregnancy, the hormone level is doubled every 24-48 hours. The lack of increments in the blood or reduction to a content of 5 MME / ml (characteristic of non-remote women and men) speaks in favor of the intrauterine fetal death. In some cases, the shell of the fetal egg is formed and synthesized, and the embryo does not develop - the hormone indicators will give a false-negative result and the diagnosis becomes ineffective.

An appointment of the diagnosis of frozen pregnancy and the interpretation of the survey results is engaged in a gynecologist. The specialist will correctly appreciate the risk of pregnancy pathology and will determine the tactics of treatment.

What to do if a frozen pregnancy is detected?

After confirming the measuring pregnancy, a dead embryo is removed from the uterus. In some case, the body independently rejects the fetus in the process of spontaneous abortion. With failed miscarriage, medical procedures and operational interventions are prescribed, which are aimed at removing the embryo and its shells.

Methods for interrupting underdeveloped pregnancy.

1. Drug - intravenous administration of drugs that increase the tone of the uterus and cause contractions. The embryo leaves the uterus naturally through the cervix and the vagina.
2. Curetzh - Cleaning the uterus of the uterus with a special surgical instrument. It is carried out under anesthesia. The cervix is \u200b\u200bexpanding, then tools are introduced into the organ cavity. The embryo and the inner shell of the uterus scratch. The technique is dangerous by the development of complications: bleeding, inflammation, infertility. This method cannot be considered gentle in early pregnancy and is assigned if other techniques are contraindicated.
3. Vacuum aspiration - gentle operational intervention by means of vacuum suction. Used for abortion in early pregnancy. The tip of the vacuum apparatus is introduced into the uterine neck without the use of expansion, and the contents of the organ, removing the embryo and the mucous membrane, are sucking.

After interrupting a frozen pregnancy, a woman should be under the supervision of a gynecologist. Perform an outpatient or inpatient treatment depending on the type of permission from the burden, the general condition of the woman, the risk of developing complications. The therapy includes the antibiotics of a wide range of action, hemostatic agents, vitamins. Recommended to refrain from planning conception for six months.

To identify the cause of the intrauterine death of the fetus for histological examination, the mucous membrane of the uterus (endometrium) and the fabric of the embryo are taken. When identifying chromosomal anomalies, the genetic advice of parents is prescribed to establish compatibility. Be sure to study the blood of a woman on the condition of the hormonal background, the analysis of the smear on the flora and the presence of genital infections. The identification of the cause of frozen pregnancy makes it possible to prevent the intrauterine death of the fetus with further planning of motherhood.

Family pregnancy is a tragic event in a woman's life, but not a sentence. When identifying the cause of pathology, you can prevent the death of the embryo, to preserve the life of the fetus during the entire period of development, give birth to a healthy child.

In the period of tooling the baby, every woman is experiencing that the development of the fetus may stop. Unfortunately, it sometimes happens. Approximately in one of three cases after fertilization, a frozen pregnancy is diagnosed. Signs in the first trimester can be different. It is about them that this article will tell you. You will learn which causes in the first trimester, and also find out about the methods of diagnosis and treatment.

What it is?

What does it have in the first trimester? Symptoms of pathology will be described below. To begin with, it is worth saying what it is.

Failure to pregnancy is the cessation of its progression. The fruit at some stage just stops developing, but does not undergo the reverse change. As a result, its decomposition and rotation of the masses may begin. It is very dangerous.

Causes of pathology

Why is a frozen pregnancy in the first trimester or later? Pathology may arise due to certain diseases. Especially dangerous infection with viruses. Such diseases can be attributed to rubella, influenza, orz, toxoplasmosis and others. Often, the fruit is undergoing changes incompatible with further development due to diseases such as chlamydia, trichomoniasis, mycoplasmosis, and so on. These pathologies are transmitted by sexual. That is why it is possible to name the frequent change of sexual partners.

A variety of can lead to a frozen pregnancy in the first trimester. Signs can manifest themselves immediately or be hidden long enough. Often, the termination of the development of the embryo occurs due to previously conducted abortions, diagnostic interventions and other manipulations on the field of the orbown body. Also here include congenital or acquired pathology of other bodies and systems. The hormonal background is played in this problem.

Another reason for measuring pregnancy can be called genetic deviations. Often, such a fetus dies back in the earliest. At the same time, the woman does not even have time to learn about his new position. In some cases, pathology develops due to external influence. For example, if the future mother consumes alcohol, drugs or leads an inappropriate lifestyle.

Measuring pregnancy: signs in the first trimester

The most reliable symptom that the fruit is no longer developing, is the lack of heartbeat. It is worth noting that in the early deadlines to check this can be exclusively using ultrasound diagnostics. At large deadlines, such manipulation can be made using a special sensor or cardiotockography apparatus.

During the study, the specialist always compares the estimated period and the size of the embryo. Much attention is paid to the fruit egg. Also, inspection is also made on the field of yellow bodies. A frozen pregnancy in the first trimester signs of ultrasound has the following:

• non-compliance of the size and timing of pregnancy;
• in some cases, the embryo is missing at all;
• the reduction of the heart muscle is not determined;
• additional defects are set (lack of a yellow body, the presence of detachment and so on).

It is worth noting that without carrying out ultrasound diagnostics, it is impossible to speak about these signs. It is this method of examination is considered the most reliable in the formulation of the described diagnosis. Consider what a frozen pregnancy signs in the first trimester still has.

Painful feelings in the stomach

Up to 70 percent of the frozen pregnancies are accompanied by pains at the bottom of the abdomen. They develop due to the fact that the body is trying to independently turn the pathological in this way the person's self-preservation system works. Pain occurs as a result of the fact that the production of certain hormones cease. The uterus becomes more sensitive and begins to shrink, the cervical canal slightly changes its position and expands. A woman can experience unpleasant drawing sensations at the bottom of the abdomen or feel strong gravity pain. Each situation is individual and does not depend on the period of pregnancy.

It is worth saying that such sensations often occur in the threat of interrupt. If there are no other hormones in the body of a woman, as well as under the influence of other factors, a reduction in the critical body can begin. This process can be reversible in the early stages. You only need to take appropriate drugs and comply with the appointment of doctors. That is why it is so important to seek help to a doctor when pain in the bottom of the abdomen in the earliest and later.

Selection of sex tract of different character

What other pregnancy has signs in the first trimester? The symptom of the development of pathology can be called allocations from the vagina. During pregnancy, especially in the early periods, their number increases. This is considered the norm. However, the color of such a fluid should be transparent or milk. Blood impurities, pus and other substances are recognized by pathology. They must be the reason for immediate appeal to the doctor.

Blood selection may say that the process of rejection of the fruit egg has already begun. As a result, small capillaries are damaged. When bleeding acquires strength, we can talk about progressive spontaneous miscarriage. In the presence of purulent secretions, a suspicion may arise that the fetal fetus occurred for quite a long time, and the process of its decomposition has already begun. It is worth noting that, as in the last paragraph, these signs may indicate only on the threat of interrupting pregnancy. The sooner you contact a gynecologist for help, the more chance to keep the child.

Sensations in the field of mammary glands

What other pregnancy has a sign of signs? Symptoms of pathology can manifest itself in the form of the disappearance of the pain and sensitivity of the mammary glands.

Under the action of pregnancy hormone (progesterone), the process of preparing for breastfeeding is beginning immediately after fertilization. Milk glands will undergo changes throughout the entire period of pregnancy. First, the chest becomes more, it becomes special sensitivity. Some women are even painful sensations. All these signs are saved to about 12 - 16 weeks. It is then that the placenta begins to work. The sharp disappearance of the sensitivity of the breast can say that the stop in the development of the fetus has occurred.

Toxicosis and its absence

What kind of pregnancy has signs in the first trimester? The embryo photo is represented by your attention in the article.

Most future mothers face toxicosis. It appears in a few weeks after fertilization and may be more or less strong. Significant causes of this state still cannot be set forth.

A sharp cessation of strong toxicosis may indicate that the pregnancy froze. This feature is indirect, but, like all of the above, requires additional diagnostics and confirmation. It is worth saying that some future mothers do not have such sensations at all. They fully transfer the first time of pregnancy. This does not mean that there is a risk of frozen pregnancy.

Basal body temperature

What is still a frozen pregnancy signs in the first trimester? The causes of pathology have already become known. Another symptom of the problem is to reduce the high level of basal temperature. If you have observed the work of your body in this way, then you may notice that immediately after ovulation there is an increase in the level of degree readings. After fertilization and implantation, it can become even higher. So, the average value of basal temperature in future mothers 37 - 37.2 degrees. If the chart line suddenly occurred to 36 - 36.5 degrees, then it can be about frozen pregnancy.

It is worth noting that this sign can only check those women who previously led the appropriate observation. Initial dimension in most cases is unreliable, because you will not be compared with.

Fever

Another sign of frozen pregnancy is to increase body temperature. It occurs due to the fact that the fruit in the uterus, begins to decompose gradually. It is worth noting that this feature appears with a long flow of the process. It can be very dangerous for a woman.

If you have risen a high temperature, and there are additional features described above, it is worth running to the hospital immediately, and it is better to call ambulance. The slightest seeping during sepsis can lead to the death of a woman.

How to find out about frozen pregnancy before ultrasound?

If you have suspicions to confirm them can only ultrasound research. Any indirect signs cannot be a reason for making a diagnosis, remember this.

There are studies that can help you learn about the problem even before diagnosing. This is a blood test. During the study, the amount of chorionic gonadotropin in your blood is determined. The results are checked with generally accepted standards. Based on this, it is possible to judge whether your real period corresponds to the intended. For more accurate diagnostics, it is recommended to conduct a study several times with a break in three or five days.

Final pregnancy in the first trimester: Treatment

If you learned about the presence of this pathology, it must be eliminated as soon as possible. In most cases, gynecological scraping is produced. In small deadlines, it is possible to use other methods of purification of the uterus, for example, a drug abortion or in some situations when the abortion (bleeding), doctors choose the expectant tactics. If a complete purification of the uterus occurs within a few days, the patient is offered cleaning. What is the frozen pregnancy in the first trimester of the consequences?

In most cases, pathology does not affect the further life and fertility of the patient. Only in particularly severe cases it may be about acquired infertility. Usually, the representative of weak sex is capable of a new pregnancy after 3 - 6 months after the incident. Often, medical preparations are prescribed by a woman after the manipulation of the manipulation. These can be antibiotics, immunomodulators, microflora recovery tools and so on.

Instead of the conclusion of the article, or short summary

You learned what kind of pregnant pregnant is the first trimester causes. This is a very unpleasant phenomenon. Especially hard it is worried about those women who have long wanted to give birth to the baby, but they do not work. If the situation with froker pregnancy is repeated more than two times, the representative of the weak gender, like its partner, is shown to consult a hematologist and genetics. In such situations, it is worth starting a full examination and find the reason why conception occurs, but the embryo at some stage simply ceases to develop. Good health and success!

Measuring pregnancy in the early and later dates: causes and prevention

- This is the termination of the development of the fetus and its death for up to 28 weeks. The reasons for this unpleasant and sometimes even dangerous phenomenon can be the most different - measuring pregnancy It may be due to genetic disorders in the embryo (or fetus), caused by the exacerbation of infectious diseases or even harmful habits. Measuring pregnancy It is more often diagnosed in the first trimester of pregnancy (up to 13 weeks). Measuring pregnancy causes in early time differ from later. Consider more such a phenomenon as measuring pregnancy reasons Its and prevention measures.

So, in the period of pregnancy planning, it is necessary to abandon the use of alcoholic beverages (especially in large quantities) and smoking. Not always alcohol and smoking leads to measuring pregnancyBut the risk of her offensive in such women increases.

Absolutely exactly during the planning period and the most pregnancy (in order to avoid miscarriage and measured) It is not necessary to use drugs without appointing a doctor. And before starting their reception, you should carefully read the instructions for the drug, maybe there is a pregnancy in contraindications. In addition, many drugs have a property for a long time output from the body. Future mom may not be aware of what came pregnancy and take any medicine and as a result - froker. The embryo is very susceptible to teratogenic action. But, meanwhile, harm will cause the reception of drugs in very early time - 7-10 days from the date of fertilization of the egg, since during this period there is no close connection between the future child and his mother. And after 8-10 weeks of the child from teratogenic exposure partially protects the placenta and, accordingly, the number measuring pregnancies In big times, it decreases somewhat. If you work in harmful production, you also have an increased risk measuring pregnancy.

May be held in violations of the hormonal background of a woman, most often, this is a lack of progesterone - pregnancy hormone. If you have a history of a frozen pregnancy, miscarriage, often happen delays in menstruation and is observed for male type, then before planning a pregnancy, you need to pass tests for hormones and if you need to undergo treatment, so you will reduce the likelihood measuring pregnancy in future.

Next reason measuring pregnancy Not only in the early, but in the later dates are all sorts of infections. It is especially dangerous not to exacerbating already available infectious diseases, but infection by them during pregnancy. Infection by some of them (for example, chickenpox and rubella) can lead not only to measuring pregnancy, but also, most terrible, fetal development anomalies. And then will have to decide on the interruption of pregnancy ... it is infections that can cause such a state as measuring pregnancy in late terms.

How to avoid measuring pregnancy Due to exacerbation or infection with infectious disease? First, you should look at your children's medical card or learn from the parents (if you yourself do not remember) whether you were transferred in childhood such diseases like rubella and windmill. If not, and besides enter the risk group (work with children), then in order to avoid infection with them and as a result measuring pregnancy Or miscarriage, better 3 months before pregnancy planning to make vaccinations from them. If you have an STIs (sexually transmitted infections), then it is necessary to get rid of them and then plan a pregnancy.

But if pregnancy emerged unexpectedly, then in order to avoid measured Or miscarriage the doctor can appoint you an antiviral course.

Everyone without exception to women for prevention measuring pregnancy And other troubles are necessary during the period of happy expectation of the baby to strengthen their immunity. There are a lot of ways, it is not necessary to drink dietary supplements and vitamins. It will be enough proper, full nutrition. During pregnancy, immunity is always reduced, this is due to the production of a special hormone - chorionic gonadotropin, one of whose functions is to protect the future child from his mother's immune system. Without this, the mother's body perceives the fruit of the fringe, as the "alien" object, from which you need to get rid of, that's another possible.

But, after all, the most often cause measuring pregnancy are genetic deviations from the fetus. Nature itself does not give to develop a "patient" embryo and arises measuring pregnancy. As a rule, if this is cause of frozen pregnancy In a woman, that is, the high probability that it will no longer happen if parents themselves are healthy.

Symptoms of frozen pregnancy and its diagnosis

Unfortunately, measuring pregnancy early Maybe not to give yourself to know. Later, symptoms of frozen pregnancy A woman can become grapple-shaped pains and cargo bleeding. This usually occurs at the beginning of a detachment of a fetal egg, that is, starting miscarriage.

To subjective symptoms froker pregnancy early You can also attribute a sharp cessation of toxicosis (if it was). Also may pass the painfulness of the mammary glands and decrease the basal temperature. Usually these symptoms of frozen pregnancy There are no fearless women. Measuring pregnancy in late terms It is characterized by the lack of a child's movements.

Can be three ways: to pass the blood test to hCG, go to the explorer to the gynecologist or do ultrasound.

For measuring pregnancy The level of hCG is lower than should be on this period of pregnancy. Uzi shows the lack of fetal heartbeat. And on the gynecological examination, the doctor determines the inconsistency of the sizes of the uterus.

So, if you suspect that you have measuring pregnancy, Know that symptoms are a secondary sign. The main thing is medical evidence if you can put it ... With such a phenomenon as measuring pregnancy symptoms Different women may vary or even absent.

Usually measuring pregnancy Ends in "cleaning" cavity of the uterus in stationary conditions. But in the early terms it is possible to conduct a vacuum aspiration or cause miscarriage with certain medicines (under the supervision of the doctor). Sometimes frosting pregnancy in early time Doctors occupy an expectant position, that is, they expect when a woman will spontaneously have miscarriage. And if this does not occur during a time-defined time or on an ultrasound, the residues of the fetal egg are diagnosed in the ultrasound in the ultrasound, they are conducted by a curethip (scraping) of the uterine cavity.

Pregnancy after frozen pregnancy

Doctors recommend planning pregnancy after frozen pregnancy At least six months. During this time for preventing future cases measuring pregnancy held treatment. Standard for treatment No, it all depends on the cause that caused frasonable pregnancy. But absolutely everyone is desirable to pass some tests and pass surveys.

First of all, it is worthwhile to hand over the smear to all sorts of infections transmitted by sexually by PCR, to hand over blood test to determine the level of hormones in the blood, to undergo an ultrasound examination. If necessary, determine the karyotype (your partner), group compatibility and other analyzes and surveys, as well as pass treatmentrecommended by the doctor based on the results of all surveys as prevention in the future measuring pregnancy.

A woman who survived such a state as family pregnancy treatment It may not be necessary at all if all the results of the analyzes are normal. As we have already written earlier measuring pregnancy, most often, happens due to a genetic error, which is unlikely to once again happen ... But if measuring pregnancy It happened not for the first time, then the treatment is most likely necessary in any case.

Best prevention is a healthy lifestyle and regular visits to the gynecologist, and then you can hardly threaten measuring pregnancy.

Measuring Pregnancy - Causes and Treatment

Untrectable pregnancy (a frozen pregnancy, failed miscarriage, Missed Ableion) means the death of the embryo (fetus) without clinical signs of miscarriage. In the structure of reproductive losses, the frequency of this pathology remains stable and is 10-20% of all desired pregnancies.

Measuring Pregnancy - Causes

The causes of undeveloped pregnancy are numerous and often complex. In everyday practice, it is often difficult to establish a specific factor that led to this pathology, since this prevents the maceration of tissues after the fetus death, which makes their genetic and morphological research.

Among the leading etiological factors of undeveloped pregnancy should first be noted infectious. Persistence in endometrials of a bacterial-viral infection often helps to strengthen or occur endocrinopathies in the mother, accompanied by disorders in the hemostasis system and metabolic changes in the mucous membrane of the uterus, which can cause the development of the embryo development (fetus).

A feature of the etiological structure of inflammatory diseases is currently various associations of microorganisms, including anaerobic bacteria, optional streptococci, viruses. This is due to a certain extent with the peculiarities of the immune response of the mother's body, in which the complete elimination of the pathogen from the body is impossible.

Not every embryo (fruit) in contact with the infection is necessarily infected; In addition, the degree of damage is different. It can be caused by microorganisms having a certain tropism to some tissues, as well as vascular failure caused by inflammation of the vessels of the fetus or placenta.

Measuring pregnancy - infections leading to the death of the fetus

The spectrum of causative agents of infections capable of causeing early antenatal infection and the subsequent death of the embryo, the following.

1. Some types of conditionally pathogenic flora - streptococci, staphylococci, E. coli, Klebsiella, etc.

2. Rush viruses, CMV, HPV, adenovirus 7, coking virus.

3.Micoplasm, chlamydia, treponam, mycobacteria.

4. Simplest - toxoplasm, plasmodia, mushrooms genus Candida.

With viral and mycoplasma damage, inflammatory changes in the decidual shell are combined with sharp circulatory disorders in the uterine-placental arteries. In case of bacterial damage, inflammatory infiltrates detect more often in amnion, chorion and intervalistic space. In the presence of infectious pathology, the mother's death of the embryo (fetus) is due to massive inflammatory infiltration, as well as micronecrosis in the place of direct contact of the chorion with maternal fabrics.

The teratogenic role of infectious diseases of the mother has been proven, it is responsible for 1- 2% of all severe innate anomalies from the fetus incompatible with life. Whether the presence of an infection causes the antenatal death of the embryo (fetus) and spontaneous interruption of pregnancy depends on the path of penetration of microorganisms, involvement in fetal infection and accumulating shells, type and virulence of microbes, the number of penetrated pathogens, the duration of the mother's disease and other factors.

The ascending path of infection of the embryo (fetus), prevailing in the first trimester of pregnancy, is due to conditionally pathogenic bacteria, as well as by mycoplasmas, chlamydia, mushrooms of the genus Candida, a virus of a simple herpes. The predisposing factors for the development of the inflammatory process may be erecting-cervical insufficiency, partial rupture of the fetal shells and carrying out some invasive manipulations in order to estimate the state of the embryo (fetus): the biopsy of chorion, amniocentesis, etc.

Microorganisms penetrate into the uterine cavity from the following departments of the reproductive system, infecting the oily water, regardless of whether their integrity is impaired or not. The fetus swallows the amniotic fluid or the infection spreads through the aircraft shells and further to the fetus, causing the lesion of the lungs, the digestive tract and the skin, which in turn may be the cause of the antenatal death of the fetus. The nature and distribution of inflammatory lesions of the organs is mainly determined by the intensive exchange of infected acid-free waters with respiratory, urinary fetal systems, as well as its gastrointestinal tract.

The descending path of infection, as a rule, begins from chronic foci of inflammation in the fallopian tubes and ovaries and is more often due to a gonorial and chlamydial infection. Inflammatory processes in uterine pickups contribute to the infection of the boundary sinuses of the placenta with the development of placental chorionnionitis, which leads to a mixed type of damage to the fetus organs and its antenatal death.

The intrauterine death of the fetus may be associated not only with the direct damaging effect of the infectious agent, but also inadequate development of immune reactions in the placenta tissue.

Measuring Pregnancy - Immunistical Causes

It is known that regulation of an immune response is carried out mainly by T-helpers, or CD4 lymphocytes. Two substances of these cells type 1 and TX type 2. They differ in secreted cytokines. TX1 secrete gamma, IL-2 and beta-flops, and TX2 - IL-4, -5 and -10. Alpha FNF secrete both subpopulations of cells, but predominantly TX1. Cytokines - Intermediaries in the development of inflammatory and immune reactions in the mother's system - a placenta - fruit. Cytokines secreted by TX, according to the feedback mechanism regulate the function of these cells. It has been established that TX2, providing mainly humoral immunity reactions, favors the physiological flow of pregnancy. TX1, on the contrary, stimulates the cellular immunity and may be an abortive effect.

There is a huge number of cells of the immune system in endometrials and decidual shell, they are all able to secrete cytokines. Violation and termination of the development of pregnancy can occur as a result of a violated immune response to antigens. As a result of this target of the cellular immunity becomes a fruit egg. Antigens activating macrophages and lymphocytes are most likely antigens of trophoblast. This is confirmed by the fact that the main cytokines secreted by TX1 suppress the development of the embryo, as well as the proliferation and normal development of the trophoblast. They affect the embryo as directly and indirectly depending on the intensity of the secretion and differentiation of the target tissue.

The immune system can lead to fetal loss through the activation of NK cells and macrophages. NK cells are directly involved in the lysis of trophoblast. Activation of macrophages contributes to increased production and secretion of cytokines that have an effect on effector cells, including NK cells. The cytokine cascade can be launched not only by the infectious agent, but also endogenous causes (hypoxia, hormones, etc.).

Chromosomal anomalies in partners, perhaps, the only one who does not doubt the cause of underdeveloped pregnancy. The death of the embryo may be due to the pathological development of the zygota, embryo, fetus or structural disorders in the genetic program for the development of the placenta. In the observations of spontaneous miscarriages due to chromosomal pathology, various violations of the embryo development are very characteristic of its complete absence.

Measuring Pregnancy - Genetic Causes

A special role in the etiology of undeveloped pregnancy belongs to chromosomal aberrations. The main number of embryos with the aberrant karyotype dying in the first weeks of pregnancy. Thus, in the first 6-7 weeks of pregnancy, the abnormal karyotypes have 60-75% of the abortures, in 12-47 weeks 20-25%, 17-28 weeks about 2-7%. Among the chromosomal abberats, the abortures 45-55% amounted to autosomal trisomy, 20-30% - monosomy 45x0, 15-20% -tritidide and 5% - tetraploidide.

Autosomal trisomy is responsible for more than half of pathological karyotypes. At the same time, as a rule, the embryo is absent or has multiple defects; The chorionic cavity is empty and small. Most autosomal trisomy are the result of the lack of chromosome discrepancy during the first mitotic division of the ovocyte, and the frequency of this phenomenon increases with the age of the mother. It should be noted that the age of the mother does not have a decisive value for other chromosomal anomalies, which are the cause of stopping the development of pregnancy.

In 20-25% of observations with the pathology of the karyotype, monosomy takes place. Monosomy X causes an aplasia of an embryo, from which only the remainder of the umbilical chopper is often preserved or the preserved embryo is in a state of pronounced water. With monosomy, 98% of pregnancies ends with miscarriage and only 2% of the child's birth with Turner syndrome.

Triploidy and tetraploidy occurred with moderate frequency, but those cases of triploidy, in which a double parent component takes place, usually lead to a partial bubble drift, clinically manifested in a later date of pregnancy.

An important structural pathology of chromosomes is translocation (2-10%), which can be transmitted by one of the parents - a balanced carrier. Balanced (compensated) translocation should be suspected whenever the spouses have an instructions for repeated undeveloped pregnancies or spontaneous miscarriages. Among other types of karyotype disorders are various forms of mosaicism, double trisomy and other rare pathology.

Chromosomal human pathology depends not only on the intensity of the mutational process, but also on the effectiveness of the selection. With age, the selection is weakened, therefore, the developmental abnormalities are more common.

Among all undeveloped pregnancies, 60% are due to blastopaths and are mainly due to chromosomal anomalies or defects caused by unfavorable external factors. Blastopathy, leading to the death of the embryo in the first weeks of pregnancy, is classified as follows.

1. Development anomalies blastocysts, amniotic cavity and yolk bag.

2. Empty germ bag due to aplasia or resorption of the embryoblast (without amnion, amniotic legs and a yellow bag).

3. The hypoplasia of the amniotic cavity with a partial or complete out-of-interest arrangement of the embryo in the whole.

4. Aplasia, hypoplasia or calcification of the yolk bag.

5. Double vices: Torakopagi, Ishopagi, etc.

6. Uncomfortable early blastopathops: anomalous blastocyst, complete topographic inversion of the Embubline.

The most frequent forms with coarse chromosomal pathology are empty germinal bags found in 14.9% of observations. Blank bags belong to malformations and allocate the following varieties.

1. With a sharply hypoplasmic amniotic cavity (in the presence of a yellow bag or without it).

2. With the absence of an embryo, umbilical umbilical bags.

3. With the presence of an amniotic shell, umbilical cord and the yolk bag (occurs in 80% of cases).

In 9.3% of observations there are changes that affect the entire embryo and thereby leading to his death.

Embrypathics are more often manifested by congenital vices, usually in the form of gross violations of the embryo development. However, part of embrypathy can also cause the intrauterine death of the embryo (fetus).

Measuring Pregnancy - Hormonal Causes

Among the reasons for undeveloped pregnancy, endocrine factors should be isolated - the violation of the formation and hypofunction of the yellow body associated with the deficiency of progesterone and the weak decidualization of the endometrium stroma. The incomplete or weak invasion of the cytotrofoblast in the adjacent endometrium helps to reduce the number and volume of gestational changes in the uterine-placental arteries and a decrease in the uterine-placental blood circulation. The consequence of this may appear the death of the embryo and the detachment of the trophoblast.

The insufficiency of the first wave of the invasion of the cytotrofoblast is often combined with chromosomal anomalies, which is a consequence of a defect responsible for this process of gene or violation of the general genetic program for the development of the embryo and placenta.

Not at all endocrine diseases, the intrauterine death of the embryo (fetus) is observed. Hyperandrogenation (matte - leventul syndrome, adrenogenital syndrome), hypo-and hyperfunction of the thyroid gland contribute to insufficient preparation of endometrials to pregnancy and defective implantation of the fetal egg, which requires a specific hormonal correction. Often, the death of the embryo (fetus) occurs in the presence of diabetes mellitus, which dictates the need to prepare for the planned pregnancy.

An autoimmune factor. One of the options for autoimmune violations is AFS.

Antiphospholipid antibodies change the adhesive characteristics of the foregoing Morula (charge); Adventure protchotic mechanisms and desynchronize the processes of fibrinolysis and fibrinetsis, which leads to defects of implantation and a decrease in the depth of the dezidal invasion of the trophoblast. Antiphospollipid antibodies directly interact with the syncytotrophoblast and cytotrofublast and inhibit the intercellular fusion of trophoblast cells. In addition, antiphospolipid antibodies suppress the production of XG and enhance thrombotic trends due to the provision of matrices for coagulation reactions.

In autoimmune diseases, severe rheological disorders are noted, leading to the formation of retroplatecentary hematoma and blockade of the uterine-placental and fetoplacementar blood circulation. Due to thromboembolic damage to the trophoblast and placenta due to damage to the cells of the endothelium of vessels and platelets, the death of the embryo (fetus) is possible.

According to literary data, without treatment, the death of embryo / fetus is observed in 90-95% of women with antiphospollipid antibodies.

Measuring pregnancy - causes of fetal death

Other factors leading to intrauterine death of the embryo (fetus). Only 10% of cases of early termination of pregnancy are associated with diseases of the mother, for example, with acute infection. More often, chronic infectious diseases of the mother do not lead to the intrauterine death of the fetus, but cause fetopathy, contributing to intrauterine death under the influence of other factors. Extremely visual example is the vices of the heart.

If we estimate the sensitivity of the embryo and the fetus to damaging factors, it can be said that the less the term of pregnancy, the fact that this sensitivity is higher. However, it decreases uneven throughout the intrauterine development. The so-called critical periods are distinguished during pregnancy, when a fruit egg, embryo, fruit is especially sensitive to unfavorable factors: the period of implantation (7-12th day), the period of embryogenesis (3-8 weeks), the period of formation of the placenta (up to 12 weeks) , the period of formation of the most important fetal functional systems (20-24 weeks).

Measuring Pregnancy - Consequences

Pathogenesis. The main pathogenetic moment of undeveloped pregnancy is the stop in the first phase of FPK with continuing uterine-placental blood circulation. The following pathologic processes characteristic of underdeveloped pregnancy are distinguished.

1. Reducing and termination of embryochorial blood circulation in combination with involutional changes in chorion vice. The borderline state between disturbed and underdeveloped pregnancy is considered the absence of erythrocytes in the selection of separately preserved vessels. This indicates an undoubted death of the embryo and the complete termination of the metabolic processes necessary for the development of pregnancy.

2. Termination of the IPC against the background of involutional changes of decidual tissue.

3. Perifocal leukocyte-fibrinous exudative endometrial reaction caused by the presence of the dead elements of the fetal egg in the uterine cavity. Its feature is a pronounced fibrinic component, due to which the biological "preservation" of embryotrofrocal residues occurs.

With undeveloped pregnancy, the phenomenon of the "reverse development of endometrial", associated with the long-term persistence of the yellow bodies of the ovary in the conditions of the gradual fetal hormone activity of the deceased fetus, can take place.

Endometrium, adjacent to the location zone of the regressive fruit bubble, can save a decidual transformation for some time, but at a greater distance has an oil refinement or hypoplastic look. With the full regression of the yellow body, the ripening of the next follicles in the ovary can begin, and then the endometrium will have signs of early, moderate or late phase of the proliferation phase. On long-term persistence of undeveloped pregnancy shows the signs of iron-cystic hyperplasia endometrial.

After the death of the embryo and stop the FPK of the walls of the vessels, the erythrocytes are found in the lumen of the capillaries, the hydropic edema (secondary) and fibrosis of the sturge of the Vorsin are observed. If there are no erythrocytes in the vessels, it can be assumed that the stopping of embryoplacementar blood circulation has arrived to 4-5 weeks of gestation; If nuclear erythrocytes prevail, the death of the embryo occurred during the yield circulation (5-9th week of pregnancy). The presence of nuclear-free erythrocytes indicates a violation of the development of the embryo already in a later date of the gestation.

Measuring Pregnancy - Signs

Clinic. The clinical sign of undeveloped pregnancy is the erased picture of the subjective manifestations of pregnancy disturbance against the background of stabilizing the size of the uterus and their inconsistency of gravidar amenorrhea. The uterus may have normal dimensions, can be reduced, can even be increased in the case of the hematoma cavity.

At the same time, as a rule, a woman in the blood in the blood is located on a maximum low level or even completely absent. The subjective signs of pregnancy are gradually disappearing (although some time after death of the embryo or fetus, a patient can feel pregnant), periodically marine bleeding outlets from sex tract, pain in a spastic abdomen.

Measuring Pregnancy - Diagnostics

Diagnostics. The diagnosis of undeveloped pregnancy is established on the basis of ultrasound scanning data in the absence of a fetal heartbeat. With ultrasound, several variants of underdeveloped pregnancy are determined.

The most commonly encountered anambrium, i.e., the absence of an embryo in the cavity of the fetal egg after 7 weeks of pregnancy. A smaller fruit egg than the proposed gestation age, the decidual shell has an intermittent circuit, the embryo is not visualized or the fruit egg in size corresponds to the period of gestation, the embryo can be visualized, but very small sizes and without heartbeat. Often there is a retrochorial hematoma. If the study is carried out on time to 8 weeks, it is necessary to repeat it after 7 days.

Another echographic picture of the underdeveloped pregnancy is "frozen fruit", in which the fruit egg and the embryo of ordinary shape and sizes without signs of fetal life is visualized. As a rule, such signs are characteristic of the recent death of the embryo, which may not be accompanied by clinical signs of the threat of interrupt.

With a longer stay of the deceased embryo in the uterus, the embryo visualization is impossible, there are no signs of its livelihood. The dimensions of the uterine are lagging behind the period of pregnancy, the structure of the fetal egg is changed sharply - the deformation, fuzzy contours and the form of the fetal egg, the presence of multiple breathtaking and individual disparate ehostructures are noted.

Of particular importance is the establishment of an echographic picture of undeveloping pregnancy, when the normal fetal may be observed transient bradycardia or syncopal lack of heartbeat, so it is necessary to observe for a few minutes. Other signs of fetal death are pronounced lowland, as well as damage to the bones of the skull with the end of bone fragments one after another.

With ultrasound, it is possible to identify a special form of undeveloped pregnancy - multipleness in early terms. Often, such women have resorption of one of the embryos in the normal development of the other. More often the regression of the fetal egg occurs by the type of anambrium, less as the type of intrauterine death of one of the fruits (with dichorial double).

Differential diagnosis of undeveloped pregnancy should be carried out with the beginning spontaneous miscarriage and trophoblastic disease.

Measuring Pregnancy - Outcome

Exodus of underdeveloped pregnancy. The death of the embryo (fetus) is not always accompanied by a rapid spontaneous exile from the uterus. The absence of any proliferative and metabolic processes on the part of the cell-fabric elements of the fetal bubble in connection with their far-closed dystrophic and necrobiotic changes are aggravated by the ashability of the uterus, which does not rejected dead fruit. There are often cases when the deceased Fercent Egg is delayed in the uterus for indefinitely for a long time.

To date, the reasons for such long-term prolongation of underdeveloped pregnancy and factors resulting in the pathological inertness of the uterus are not enough. Apparently, the ashautility of the uterus can be associated with the following factors.

1. Deep invasion of chorion vigor, providing a dense attachment or true increment of the forming placenta due to:

o enhanced proliferative activity of invasive chorion in the area of \u200b\u200bthe placental site;

o of the initial structural-functional inferiority of the endometrium in the implantation zone in connection with the preceding scraping of the uterus;

o Implantation of a fruit egg in places of incomplete gravidar transformation of the mucous membrane of the uterus.

2. The inferiority of the reactions of immunocloty rejection of the deceased frenule bubble. A cascade of immunocloty reactions aimed at rejection of the "allogenic transplant", which has lost all immunoblocating factors in connection with its death. With a certain genetic identity of the spouses (related marriage), the biological compatibility of the mother and the fetus may be so close as it necessarates the state of the immunological asure of the uterus in relation to the deceased germin.

3. The apeactivity of the uterus. The contracting hypofunction of myometrium may be due to:

o biochemical defects in the system of enzymatic-protein metabolism;

o chronic inflammatory processes in the uterus, when receptors for cutting substances are not formed;

o The lack of hormonal support from the dead fetus and the undeveloping placenta.

Most often, there is a gradual rejection of the deceased egg with a fibrin-leukocyte exudative reaction in response to necrotic fabric. During this process, along with fibrinis and leukocytes from endometrial vessels, trophoblastic, thromboplastic substances, and red blood cells are distinguished, which leads to permanent separating bleeding out of the uterus. The body of the uterus becomes soft, myometrium tone disappears, the neck opens. All signs of pregnancy (cyanosis of the vagina, cervix) disappear.

Measuring pregnancy - the consequences of staying dead embryo in the uterus

With long-term (2-4 weeks or more) finding a dead embryo in the uterus there are autolysis, the flow of thromboplastic substances in the patient's blood flow and develops in DVS syndrome. All this is the risk of developing severe coagulopathic bleeding while trying to interrupt pregnancy. The most unfavorable uterine hemostasis conditions occur in patients who have phase hemochaguing changes are in a state of hypocoagulation and is expressed by myometrics.

The difficulties arising from the removal of a dead fetus can be due to the preservation of chorion, placenta located in the field of the inner domestic uterine. Before scraping the uterus, it is necessary to investigate the state of the hemostasis system (deployed coagulogram). With the identified disorders (hyperagregation, hypercoagulation, DVS syndrome), corrective therapy is necessary (freshly frozen, and other components). The binding of hemostasiological disorders at the level of vascular-plateitarian facilities contributes to the use of dicinos and ATP. In the postoperative period, antiagregative and anticoagulant therapy (, kuralutyl,) is shown. The energy potential of the uterus is reduced by the purpose of glucose, vitamins, calcium chloride in combination with antispasmodic preparations.

Measuring Pregnancy - Treatment

Treatment. The delay in the dead embryo in the uterine cavity is a threat not only to the health, but also the life of a woman and therefore requires active tactics. As soon as the diagnosis of underdeveloped pregnancy, long-term conservative patient maintenance is risky.

After a thorough examination and appropriate preparation of a woman (conducting medical and preventive measures aimed at reducing the risk of development of possible

complications) Need an interruption of underdeveloped pregnancy. In the first trimester of pregnancy:

1. Expansion of the cervix and vacuum aspiration.

2. Preparation of the cervix with prostaglandins or hydrophilic expanders and vacuum aspiration.

3. Use of antiproatagennes in combination with prostaglandins.

In the II trimester of pregnancy:

1. Expansion of the cervix and evacuation of the products of conception with the preceding preparation of the cervix.

2. Therapeutic abortion with the help of intra-and extraimotic administration of prostaglandins or hypertensive agents.

3. The use of antiprogestogen in combination with prostaglandin.

4. Isolated use of prostaglandins.

Directly during the abortion or immediately after its completion, it is necessary to carry out ultrasound scanning to make sure that the fetus and placenta are removed.

After removal of the fetal egg with undeveloped pregnancy, regardless of the chosen interrupt method, it is advisable to carry out a complex anti-inflammatory treatment, including a specific antibacterial, immunocorrorizing and generalifying therapy.

Each case of undeveloped pregnancy requires an in-depth examination with respect to genetic, endocrine, immune and infectious pathology.

Measuring Pregnancy - Medical Events

The tactics of conducting patients with undeveloped pregnancy is as follows.

1. Detection of pathogenetic death factors of the embryo (fetus).

2. Elimination or weakening of the detected factors outside and during pregnancy:

o screening examination of patients planning pregnancy, as well as women in early gestation for urogenital infection;

o Medical and genetic counseling in order to identify high-risk groups in congenital and hereditary pathology;

o differentiated individually selected hormone therapy in the endocrine genesis of undervolving pregnancy;

o Determination of autoimmune disorders (determination of the lupus anticoagulant, anti-xg, anti-kardolypin antibodies, etc.) and the individual selection of antiagregants and / or anticoagulants and glucocorticoids under the control of hemostasiograms.

3. Normalization of the mental state of a woman (sedatives, propaganda of a healthy lifestyle).

Pregnancy after frozen pregnancy

Tactics of conducting patients with subsequent pregnancy as follows.

1. Screening using non-invasive methods: ultrasound examination, analysis of alpha-fetoprotein marker serum proteins, chorionic gonadotropin in the blood in the most informative time.

2. According to the indications - invasive prenatal diagnosis of the determination of chromosomal and a number of monogenic diseases of the fetus.

3. Conducting medical and preventive measures aimed at:

o the elimination of the infectious process, conducting specific anti-inflammatory therapy in combination with immunocorrectors;

o Suppression of autoantile products - intravenous drip administration of gammaimmunoglobulin at 25 ml in day No. 3;

o The elimination of hemostasiological disorders - antiagregants, direct action anticoagulants.

Spontaneous abortion (miscarriage)

Spontaneous abortion (miscarriage) is a spontaneous interruption of pregnancy until the fruit of a viable gestational period is achieved.

According to the determination of WHO, the abortion is spontaneous expulsion or extraction of an embryo or fetus weighing up to 500 g, which corresponds to the period of gestation less than 22 weeks.

Code of the ICD-10

O03 Spontaneous abortion.
O02.1 The failed miscarriage.
O20.0 Threatening abortion.

EPIDEMIOLOGY

Spontaneous abortion is the most frequent complication of pregnancy. Its frequency ranges from 10 to 20% of all clinically diagnosed pregnancies. About 80% of these losses occurs up to 12 weeks of pregnancy. When taking into account pregnancies to determine the level of hCG, the frequency of losses increases to 31%, and 70% of these abortions occurs until the moment when pregnancy can be recognized clinically. In the structure of sporadic early miscarriages of 1/3 of pregnancies, it is interrupted in the period of up to 8 weeks by the type of anambrony.

CLASSIFICATION

Clinical manifestations distinguish:

· Threatening abortion;
· Abortion started;
· Abortion in the go (full and incomplete);
· NB.

The classification of spontaneous abortions, adopted by WHO, is slightly different from the such used in the Russian Federation, combining the beginning of the miscarriage and abortion in the go to one group - the inevitable abortion (i.e., the continuation of pregnancy is impossible).

ETIOLOGY

The leading factor in the etiology of spontaneous interruption of pregnancy is chromosomal pathology, the frequency of which reaches 82-88%.

The most frequent variants of chromosomal pathology with early spontaneous miscarriages are autosomal trisomy (52%), monosomy X (19%), polyploidy (22%). Other forms are noted in 7% of cases. In 80% of cases, death is at first, and then the expulsion of the fruit egg.

The second most important among etiological factors is metronendometritis of various etiology, which causes inflammatory changes in the mucous membrane of the uterus and preventing normal implantation and the development of the fruit egg. Chronic productive endometritis, more often autoimmune genesis, was noted in 25% of the so-called reproductive healthy women who have interrupted by the pregnancy by artificial abortion, in 63.3% of women with habitual unbearabity and in 100% of women with NB.

Among other causes of sporadic early miscarriages, anatomical, endocrine, infectious, immunological factors, which, mostly serve as the causes of familiar miscarriage, are distinguished.

RISK FACTORS

Age is one of the main risk factors in healthy women. According to data obtained in the analysis of outcomes of 1 million pregnancies, in the age group of women from 20 to 30 years, the risk of spontaneous abortion is 9-17%, at 35 years - 20%, at 40 years - 40%, at 45 years old - 80%.

Parity. In women with two pregnancies and more in history, the risk of miscarriage is higher than that of born women, and this risk does not depend on age.

The presence of spontaneous abortions in history. The risk of miscarriage increases with the increase in the number as such. In women with one spontaneous miscarriage in history, the risk is 18-20%, after two miscarriages it reaches 30%, after three miscarriages - 43%. For comparison: the risk of miscarriage in a woman, the previous pregnancy of which ended successfully, is 5%.

Smoking. Consumption of more than 10 cigarettes per day increases the risk of spontaneous abortion in the first trimester of pregnancy. These data are most indicative when analyzing spontaneous interruption of pregnancies in women with a normal chromosomal set.

The use of non-steroidal anti-inflammatory funds in the period preceding conception. Data obtained indicating the negative impact of the oppression of GHG synthesis for the success of implantation. When using non-steroidal anti-inflammatory funds in the period preceding conception, and in the early stages of pregnancy, the frequency of miscarriages was 25% compared with 15% in women who did not receive drugs of this group.

Fever (hyperthermia). An increase in body temperature above 37.7 ° C leads to an increase in the frequency of early spontaneous abortions.

Injury, including invasive methods of prenatal diagnostics (choriocentesis, amniocentesis, corecentesis), risk is 3-5%.

Caffeine use. With daily consumption of more than 100 mg of caffeine (4-5 cups of coffee), the risk of early miscarriage increases reliably, and this trend is valid for the fetus with a normal karyotype.

The effects of teratogen (infectious agents, toxic substances, teratogenic effects) also serves as a risk factor in spontaneous abortion.

Folic acid deficiency. At the concentration of folic acid in serum less than 2.19 ng / ml (4.9 nmol / l), the risk of spontaneous abortion from 6 to 12 weeks of pregnancy is significantly increased, which is associated with a greater frequency of the formation of an abnormal karyotype of the fetus.

Hormonal disorders, thrombophylastic states are more reasons for not sporadic, but the familiar miscarriage, the main reason for which the defective lutein phase acts.

According to numerous publications, from 12 to 25% of pregnancies after Eco end with spontaneous abortion.

Clinical picture and diagnostics

Basically, the patients complain about the bleeding of sex tract, pain at the bottom of the abdomen and in the lower back when menstruation delay.

Depending on clinical symptoms, there is a threatening spontaneous abortion, which began, abortion in the go (incomplete or complete) and NB.

A threatening abortion is manifested by pulling pain at the bottom of the abdomen and lower back, there may be scarce bleeding from sex tract. The tone of the uterus is raised, the cervix is \u200b\u200bnot shortened, the inner zev is closed, the body of the uterus corresponds to the term of pregnancy. With ultrasound, the fetal heartbeat is recorded.

With the abortion of pain and bleeding from the vagina more pronounced, the cervical channel is ajar.

With abortion in the go, regular grapple-shaped reductions of the myometrium are determined. The magnitude of the uterus is less than the alleged period of pregnancy, in a later date of pregnancy it is possible to leak. Inner and outer zev are open, elements of a fetal egg in the cervical channel or in the vagina. Blood discharge can be of different intensity, more often abundant.

An incomplete abortion is a condition conjugate with a delay in the uterus of the elements of the fetal egg.

The absence of a complete reduction in the uterus and the closure of its cavity leads to continuing bleeding, which in some cases the cause of large blood loss and hypovolemic shock is caused.

More often, an incomplete abortion is observed after 12 weeks of pregnancy in the case when the miscarriage begins with an effusion. With a bimanual study of the uterus, there is less than the estimated period of pregnancy, bleeding from the cervical cervical channel, with the help of ultrasound in the uterus, the remains of the fetal egg are determined, in the II trimester - the remains of placental tissue.

A complete abortion is more often observed in the late period of pregnancy. A fruit egg is completely from the uterus.

The uterus is cut, bleeding stops. With a bimanual study, the uterus is well contacted, less than the period of gestation, the cervical channel can be closed. With full miscarriage using ultrasound, the uterus is determined. There may be small bleeding.

An infected abortion is a condition accompanied by fever, chills, ailments, pain at the bottom of the abdomen, bloody, sometimes with fidelled seals from the genital tract. In physical inspection, tachycardia, tachipne, defans of the muscles of the anterior abdominal wall, with a bimanual study - painful, soft consistency with the uterus; The cervical channel is expanded.

With an infected abortion (with a mixture of bacterial radiation infections and autoimmune disorders in women with familiar non-obscure, burdened by the antenatal death of the fetus by an obstetric history, recurrent flow of genital infections) are prescribed immunoglobulins intravenously (50-100 ml of 10% solution of Hamimun, 50- 100 ml of 5% octagam solution and etc.). Also the extracorporeal therapy is also carried out (plasmapheresis, cascade plasmailtration), which lies in the physicochemical blood purification (removal of pathogenic autoantibodies and circulating immune complexes). The use of cascade plasmailtration implies disintellation without plasma removal. In the absence of treatment, it is possible to generalize infection in the form of salpingitis, local or spilled peritonitis, septicemia.

Untrectable pregnancy (the antenatal fetal death) - the death of an embryo or fetus during pregnancy for a period of less than 22 weeks in the absence of an expulsion of the elements of the fetal egg from the uterine cavity and often without signs of the threat of interrupt. For the diagnosis, an ultrasound is carried out. Pregnancy interrupt tactics are chosen depending on the period of gestation. It should be noted that the antenatal fetal death is often accompanied by violations of the hemostasis system and infectious complications (see chapter "Untrevive Pregnancy").

In the diagnosis of bleeding and developing tactics of reference in the I trimester of pregnancy, the speed of the speed and volume of blood loss plays a decisive role.

With ultrasound, unfavorable signs in terms of the development of a fruit egg in a uterine pregnancy consider:

· The lack of the heartbeat of the embryo with the CTR is more than 5 mm;

· Lack of embryo in the sizes of the fetal eggs measured in three orthogonal planes, more than 25 mm during transabdominal scanning and more than 18 mm during transvaginal scanning.

Additional ultrasound signs indicating an adverse outcome of pregnancy include:

· Anomalous yolk bag, not appropriate gestation (more), irregular shape, offset to the periphery or calcified;

· Embrycos CSS less than 100 per minute on time 5-7 weeks;

· Large dimensions of retrocharial hematoma (more than 25% of the surface of the fetal egg).

Differential diagnosis

The spontaneous abortion should be differentiated with benign and malignant diseases of the cervix or vagina. During pregnancy, bleeding from ectropion is possible. To eliminate the diseases of the cervix, a cautious inspection in the mirrors, if necessary, colposcopy and / or biopsy.

Blood sections when miscarriage differentiate with those with an anoint cycle, which are often observed when menstruation delay. There are no symptoms of pregnancy, the test on the BSUBID HCG is negative. With a bimanual study of the uterus of normal sizes, not softened, the neck is dense, not cyanotic. Anamnesis may be similar disorders of the menstrual cycle.

Differential diagnosis is also carried out with bubble drift and ectopic pregnancy.

With bubble drift in 50% of women there may be characteristic allocations in the form of bubbles; The uterus may be more sense of pregnancy. Characteristic picture with ultrasound.

With ectopic pregnancy, women may complain about bleeding, bilateral or generalized pain; Frequently unforgettable states (hypovolemia), a sense of pressure on a straight intestine or bladder, a test for BXHch positive. With a bimanual study, there is a soreness when moving over the cervix. The uterus of smaller sizes than should be on the period of the proposed pregnancy.

You can proper a thickened uterine tube, often swelling of the arch. When ultrasound in the uterine tube, a fruit egg can be defined, with its break to detect the blood cluster in the abdominal cavity. To clarify the diagnosis, the puncture of the abdominal cavity through the rear vaginal arch or diagnostic laparoscopy is shown.

An example of the formulation of diagnosis

Pregnancy 6 weeks. The started miscarriage.

Treats of treatment

The goal of treating the threat of abortion is the relaxation of the uterus, stopping bleeding and prolongation of pregnancy in the case of a viable embryo or fetus in the uterus.

In the USA, Western European countries, the threatening miscarriage up to 12 weeks are not treated, believing that 80% of such miscarriages are "natural selection" (genetic defects, chromosomal abbrasions).

In the Russian Federation, the other tactic of pregnant women with the threat of miscarriage is generally accepted. With this pathology, the bed regime (physical and sexual peace) is prescribed, a full diet, gestagens, methylxantins, and as symptomatic treatment - antispasmodic preparations (, candles with papaverine), vegetable sedative drugs (dustwater decoction, valerian).

Non-media treatment

In the diet of pregnant, oligopeptides, polyunsaturated fatty acids, must be included.

Medicia treatment

Hormone therapy includes natural micronized 200300 mg / day (preferable) or Didrogesterone 10 mg twice a day, vitamin E of 400 me / day.

DROTAVERINA is prescribed with expressed pain intramuscularly at 40 mg (2 ml) 2-3 times a day, followed by a transition to oral administration from 3 to 6 tablets per day (40 mg in 1 tablet).

Methylxantins - (7 mg / kg body weight per day). Candles with papaverine at 20-40 mg twice a day apply rectally.

Approaches to therapy for the threat of pregnancy interrupt fundamentally vary in the Russian Federation and abroad. Most foreign authors insist on the inexpediency of pregnancy to pregnancy for a period of less than 12 weeks.

It should be noted that the effect of the use of any therapy - drug (antispasmodics, progesterone, magnesium preparations, etc.) and non-drug (protective mode) - not proven in randomized multicenter studies.

Purpose in the bleeding discharges of pregnant agents affecting hemostasis (ethimsite, viscasol, transkamic acid, aminocaproic acid and other drugs), does not have grounds and proven clinical effects due to the fact that bleeding during miscarriages is due to the chorion detachment (early placenta), And not coagulation violations. On the contrary, the task of the doctor is to prevent blood loss leading to hemostasis violations.

When entering the hospital, blood test should be carried out, determine the blood group and resusperation.

In case of incomplete abortion, abundant bleeding is often observed, in which it is necessary to provide emergency care - to immediately instrumental removal of the residual eggs and scraping the walls of the uterine cavity. More careful is the emptying of the uterus (preferably vacuumspiration).

Due to the fact that it can have an antidiuretic effect, after emptying the uterus and stop bleeding, the introduction of large doses of oxytocin must be discontinued.

In the process of operation and after it, it is advisable to introduce an intravenously isotonic solution of sodium chloride with oxytocin (30 units per 1000 ml of solution) at a rate of 200 ml / h (in the early period of pregnancy, the uterus is less sensitive to oxytocin). It is also carried out antibacterial therapy, if necessary, treatment of postgemorrhagic anemia. Women with resound negative blood is introduced immunoglobulin antveusus.

It is advisable to control the state of the uterus by the Uzi method.

With a complete abortion during pregnancy, less than 14-16, it is advisable to conduct an ultrasound and, if necessary, scraping the walls of the uterus, since the likelihood of finding parts of the fetal egg and decidual fabric in the uterine cavity. In a later dates, with a well-cutting uterus, scraping are not produced.

It is advisable to appoint antibacterial therapy, treatment of anemia according to the testimony and administration of immunoglobulin antveusus women with resound negative blood.

SURGERY

Surgical treatment of NB is presented in the chapter "Untrevive Pregnancy".

Postoperative period

Women with aite in history (endometritis, salpingitis, ooforite, tubarial abscess, pelvioeritonitis) Antibacterial therapy should be continued for 5-7 days.

In resuscant-negative women (during pregnancy from the resuspend partner) in the first 72 hours after vacuumspiration or scraping during pregnancy, more than 7 weeks and in the absence of massate, the anti -usus in a dose of 300 μg (intramuscular) is carried out in the absence of resusat.

Prevention

Methods of specific prophylaxis of sporadic miscarriage are absent. For the prevention of nervous tube defects, which partially lead to early spontaneous abortions, recommend the appointment of folic acid for 2-3 menstrual cycles before conception and in the first 12 weeks of pregnancy in the daily dose of 0.4 mg. If a history of the woman's nervous tube defects are noted in history during previous pregnancies, the preventive dose should be increased to 4 mg / day.

Information for the patient

Women should be informed about the need to appeal to the doctor during pregnancy when the abdominal appearance appears at the appearance of the abdomen, in the lower back, in the occurrence of bleeding out of the genital tract.

Further maintenance

After the scraping of the uterine or vacuumspiration, it is recommended to exclude the use of tampons and refrain from sex contacts for 2 weeks.

As a rule, the forecast is favorable. After one spontaneous miscarriage, the risk of losing the next pregnancy increases slightly and reaches 18-20% compared with 15% in the absence of miscarriage in history. In the presence of two consecutive spontaneous interruptions of pregnancy, it is recommended to conduct a survey before the occurrence of desired pregnancy to identify the causes of unbearable from this marital pair.

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